3 Ways to Fight the Fear Your Breast Cancer Will Come Back

Survivors of breast cancer are commonly haunted by fears that the disease will return, especially during the first few years of recovery. "Breast cancer is a wily disease," says Julia Rowland, PhD, director of the National Cancer Institute's Office of Cancer Survivorship. It can return 10, even 20 years later. But after your first year, each year without a recurrence marks an important drop in your risk.

Yet, for many, the fears still linger. Some survivors and others just concluding treatment are always "waiting for the other shoe to drop," says Karen R. Monaghan, LICSW, a clinical oncology social worker at Dana-Farber Cancer Institute in Boston.

What do you need to get through this?

1. A follow-up care plan
Two major medical reports—from the President's Cancer Panel in 2004, and the Institute of Medicine of the National Academies in 2005—have recommended that doctors create follow-up plans for their cancer patients. These would include such things as a summary of your diagnosis and treatment; information on who will oversee your case; how often you should come in for checkups and what kind you need; what lifestyle changes might be appropriate to lower your risk of recurrence and improve your overall health; and information on support services for down the road. Ask your doctor to write one up; the American Society of Clinical Oncologists' online guide to follow-up care for breast cancer patients can help start this conversation. Knowing what to expect for the long haul can be comforting and empowering.

2. Regular checkups—once they're done
These can be reassuring, but the days before can be a particularly stressful time for many survivors.

3. Coping strategies
These may include breathing exercises, stress management techniques, or talking to other women with the same concerns in support groups or online bulletin boards. If you find that you have a high level of anxiety that lasts for several weeks, you may want to seek professional assistance, such as from a therapist.